Healthcare Provider Details
I. General information
NPI: 1063301364
Provider Name (Legal Business Name): REROUTING REALITY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6726 MORGANTON RD # 176
GREENBACK TN
37742-2464
US
IV. Provider business mailing address
6726 MORGANTON RD # 176
GREENBACK TN
37742-2464
US
V. Phone/Fax
- Phone: 254-466-0274
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WHITNEY
WEAVER
Title or Position: THERAPIST
Credential: LPC
Phone: 254-466-0274